Substitution Preferences for Sugar-Sweetened Beverages Among US Adults by Sociodemographic Characteristics – SummerStyles 2021

Purpose This study examined preferences to consider low-calorie, no sugar substitution options for sugar-sweetened beverage (SSB) among US adults. This could help develop tailored public health strategies to reduce SSB consumption and related health risks. Design Quantitative, cross-sectional study. Setting United States. Sample This study used 2021 SummerStyles survey data for 2552 US adults recruited from an online panel of approximately 60 000 non-institutionalized adults. Measures The outcome measure was considering a non-sugar SSB substitute (Yes or no) for six different beverage options among individuals consuming SSBs who would consider a substitute. Exposure measures were sociodemographic characteristics and frequency of SSB consumption. Analysis Logistic regression models were used to estimate adjusted odds ratios (ORs) for preference to consider each substitution option. Results Plain water was considered by 71% of respondents as a substitute; 36% considered flavored water, 27% sparkling water, 25% herbal tea, 19% diet drinks, and 18% unsweetened coffee. Preferences varied by demographic characteristics. Individuals reporting an annual household income of <$35 000 had 0.6 (95% confidence interval (CI): 0.4, 0.9) times lower odds to consider plain water than those with income ≥$100 000, and individuals with obesity had 1.9 (95% CI: 1.4, 2.6) times greater odds of considering diet drinks compared to those with healthy weight or underweight. Conclusion Population subgroups of regular SSB-consuming adults exhibit varying preferences for SSB substitutes, which can inform tailored public health messaging and interventions.